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Survey of Ct Radiation Doses and Iodinated Contrast Medium Administration: An International Multicentric Study Publisher



Karout L1 ; Kalra MK2 ; Kaviani P1 ; Dasegowda G1 ; Garzafrias E1 ; Fahimi R1 ; Rawashdeh M2 ; Saade C3 ; Digumarthy SR1 ; Abighanem AS3 ; Hosseini S1 ; Saba L4 ; Ebrahimian S1 ; Vora TP1 Show All Authors
Authors
  1. Karout L1
  2. Kalra MK2
  3. Kaviani P1
  4. Dasegowda G1
  5. Garzafrias E1
  6. Fahimi R1
  7. Rawashdeh M2
  8. Saade C3
  9. Digumarthy SR1
  10. Abighanem AS3
  11. Hosseini S1
  12. Saba L4
  13. Ebrahimian S1
  14. Vora TP1
  15. El Mais H5
  16. Jabbour Y3
  17. Aly A6
  18. Naffaa L7
  19. Kassab MB1
  20. Nassar M8
  21. Bernardo M9
  22. Oyetayo BT10
  23. Yaseen ABB11
  24. Owda ZM12
  25. Gabutti JA13
  26. Musa KM14
  27. Shrestha R15
  28. Al Qudah HRH16
  29. Ilaghi M17
  30. Esfahani MM18
  31. Ghonim MA19
  32. Hailat MZ20
  33. Ibrahim MK21
  34. Anand R22
  35. Rackimuthu S23
  36. Shrivastava A24
  37. Shapouran A25
  38. Shafieyoon S26
  39. Chamma L27
  40. Awas AA28
  41. Panchal VS29
  42. Parikh VR24
  43. Teixeira BCDA30
  44. Amleshi RS17
  45. Safarini OA12
  46. Lucena RA31
  47. De Castro DF32
  48. Aljarrah MO33
  49. Shahidi R34
  50. Khazaei M34
  51. Kotian RP35
  52. Kotian DR36
  53. Alshunaigat NAN37
  54. Alkuwari MAA6
  55. Alkhulaifat D38
  56. Kilincer A25
  57. Thawabah AF39
  58. Chowdhary A40
  59. Goedert GM9
  60. Abs L41
  61. Gallegos FEP42
  62. Nassar N2
  63. Segota D43
  64. Rizzo V8
  65. Jabi MNA38
  66. Cau R4
  67. Gampala S44
  68. Arvind S45
  69. Pinheiro AMA46
  70. Mokrian H47
  71. Sabry KAA19
  72. Abu Zaineh A48
  73. Chaaban AK49
  74. Nasr AM49
  75. Marciano L50
  76. Kiipper FM50
  77. Real JV32
  78. Negrerososuna AA51
  79. Huertasanchez MC51
  80. Mora JAG52
  81. Yohannan S53
  82. Christie O44
  83. Ghonim MA19
  84. Safavinaini SAA54
  85. Deshmukh A40
  86. Maliyekkal ST6
  87. Agrawal V55
  88. Kumar M55
  89. Tarawneh L18
  90. Panchal K29
  91. Richie AJ23
  92. Vaidya VN56
  93. Taiye AM14
  94. Koolivand S47
  95. Shayganfar A26
  96. Talari H18
  97. Moscatelli A46
  98. Gershan V57
Show Affiliations
Authors Affiliations
  1. 1. Massachusetts General Hospital, Boston, MA, United States
  2. 2. Faculty of Applied Medical, Jordan University of Science and Technology, Irbid, Jordan
  3. 3. American University of Beirut, Beirut, Lebanon
  4. 4. University of Cagliari: Universita degli Studi Di Cagliari, Cagliari, Italy
  5. 5. University of Ottawa Heart Institute, Ottawa, Canada
  6. 6. Hamad General Hospital, Doha, Qatar
  7. 7. Department of Diagnostic Radiology, University of Central Florida, Orlando, FL, United States
  8. 8. Icahn School of Medicine at Mount Sinai, New York, NY, United States
  9. 9. Pontifical Catholic University of Parana, Curitiba, Brazil
  10. 10. Lagos University Teaching Hospital, Lagos, Nigeria
  11. 11. Isra University, Hyderabad, Pakistan
  12. 12. An-Najah National University Hospital, Nablus, Palestine
  13. 13. Institute Nacional De Ciencias, Mexico, Brazil
  14. 14. Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria
  15. 15. Upendra Devkota Memorial National Institute of Neurological and Allied Science, Kathmandu, Nepal
  16. 16. King Abdullah University Hospital, Ar-Ramtha, Jordan
  17. 17. Kerman University of Medical Sciences, Kerman, Iran
  18. 18. Kashan University of Medical Sciences, Kashan, Iran
  19. 19. Ain Shams University, Cairo, Egypt
  20. 20. Al Kindi Hospital, Amman, Jordan
  21. 21. Mayo Clinic in Rochester, Rochester, MN, United States
  22. 22. All India Institute of Medical Sciences, New Delhi, India
  23. 23. Father Muller Medical College, Mangalore, India
  24. 24. SRL Diagnostic Vadodara, Vadodara, India
  25. 25. Selcuk University, Alaeddin Keykubat Campus, Selcuk Universitesi, Konya, Turkey
  26. 26. Isfahan University of Medical Sciences, Isfahan, Iran
  27. 27. Lebanese International University, Beirut Campus, The International University of Beirut, Beirut, Lebanon
  28. 28. University of Science and Technology Hospital, Sana’a, Yemen
  29. 29. Smt NHL Municipal Medical College, Ahmedabad, India
  30. 30. Hospital de Clinicas, Sao Paulo, Brazil
  31. 31. Centro de Diagnostico da Unimed Porto Alegre, Porto Alegre, Brazil
  32. 32. Federal University of Parana: Universidade Federal do Parana, Curitiba, Brazil
  33. 33. King Abdulaziz Hospital, Jeddah, Saudi Arabia
  34. 34. Bushehr University of Medical Sciences, Bushehr, Iran
  35. 35. Burjeel Hospital, Dubai, United Arab Emirates
  36. 36. Shri Jagdishprasad Jhabarmal Tibrewala University, Churela, India
  37. 37. Amman Arab University, Amman, Jordan
  38. 38. King Hussein Cancer Center, Amman, Jordan
  39. 39. Sana’a University, Sana’a, Yemen
  40. 40. Bridgeport Hospital, Bridgeport, CT, United States
  41. 41. Nini Hospital, Tripoli, Lebanon
  42. 42. Hospital Zambrano Hellion, San Pedro Garza Garcia, Mexico
  43. 43. Clinical Hospital Center Rijeka, Rijeka, Croatia
  44. 44. SUNY Upstate Medical University Hospital, Syracuse, NY, United States
  45. 45. Bangalore Medical College and Research Institute: Bangalore Medical College, Bengaluru, India
  46. 46. Unimed do Brasil, Sao Paulo, Brazil
  47. 47. Hamadan University of Medical Sciences, Hamedan, Iran
  48. 48. Universite Setif, Setif, Algeria
  49. 49. Rafik Hariri University Hospital, Jnah, Lebanon
  50. 50. Hospital Sirio-Libanes, Sao Paulo, Brazil
  51. 51. Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Mexico
  52. 52. Instituto de Ciencias Medicas: Instituto de Ciencias Medica, Alicante, Panama
  53. 53. The Maharaja Sayajirao University of Baroda, Vadodara, India
  54. 54. Shahid Beheshti University of Medical Sciences Research Institute for Gastroenterology and Liver Diseases, Tajrish, Iran
  55. 55. King George’s Medical University, Lucknow, India
  56. 56. GMERS Medical College and Hospital, Gandhinagar, India
  57. 57. International Atomic Energy Agency, Vienna, Austria

Source: European Radiology Published:2024


Abstract

Objective: To assess the relationship between intravenous iodinated contrast media (ICM) administration usage and radiation doses for contrast-enhanced (CE) CT of head, chest, and abdomen–pelvis (AP) in international, multicenter settings. Methods: Our international (n = 16 countries), multicenter (n = 43 sites), and cross-sectional (ConRad) study had two parts. Part 1: Redcap survey with questions on information related to CT and ICM manufacturer/brand and respective protocols. Part 2: Information on 3,258 patients (18–96 years; M:F 1654:1604) who underwent CECT for a routine head (n = 456), chest (n = 528), AP (n = 599), head CT angiography (n = 539), pulmonary embolism (n = 599), and liver CT examinations (n = 537) at 43 sites across five continents. The following information was recorded: hospital name, patient age, gender, body mass index [BMI], clinical indications, scan parameters (number of scan phases, kV), IV-contrast information (concentration, volume, flow rate, and delay), and dose indices (CTDIvol and DLP). Results: Most routine chest (58.4%) and AP (68.7%) CECT exams were performed with 2–4 scan phases with fixed scan delay (chest 71.4%; AP 79.8%, liver CECT 50.7%) following ICM administration. Most sites did not change kV across different patients and scan phases; most CECT protocols were performed at 120–140 kV (83%, 1979/2685). There were no significant differences between radiation doses for non-contrast (CTDIvol 24 [16–30] mGy; DLP 633 [414–702] mGy·cm) and post-contrast phases (22 [19–27] mGy; 648 [392–694] mGy·cm) (p = 0.142). Sites that used bolus tracking for chest and AP CECT had lower CTDIvol than sites with fixed scan delays (p < 0.001). There was no correlation between BMI and CTDIvol (r2 ≤ − 0.1 to 0.1, p = 0.931). Conclusion: Our study demonstrates up to ten-fold variability in ICM injection protocols and radiation doses across different CT protocols. The study emphasizes the need for optimizing CT scanning and contrast protocols to reduce unnecessary contrast and radiation exposure to patients. Clinical relevance statement: The wide variability and lack of standardization of ICM media and radiation doses in CT protocols suggest the need for education and optimization of contrast usage and scan factors for optimizing image quality in CECT. Key Points: There is a lack of patient-centric CT protocol optimization taking into consideration mainly patients’ size. There is a lack of correlation between ICM volume and CT radiation dose across CT protocol. A ten-fold variation in iodine-load for the same CT protocol in sites suggests a lack of standardization. © The Author(s), under exclusive licence to European Society of Radiology 2024.
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